Your baby came to the cardiologist for evaluation of a heart murmur and the doctor tells you that your newborn has mild PPS, peripheral pulmonary stenosis. Then they tell you that this is a common finding in newborn babies and that you shouldn't worry. But it sounds terrifying! So what is it?
Peripheral pulmonary stenosis, PPS, is the term used to describe narrowing of the arteries that take de-oxygenated (blue) blood from the right ventricle to the lungs. Some doctors may also call it branch pulmonary artery stenosis, because it occurs at the branch points of the main pulmonary artery.
So why does this occur? Most of the time, peripheral pulmonary stenosis is an innocent finding. In all infants, the lungs are not fully developed at birth. In fact, it takes several months after birth for the lungs to complete their growth and development process. For some infants, this means that the arteries taking blood to the lungs may not be fully grown for the first few months as well. The relative stenosis, or tightness, of the pulmonary arteries can cause the blood flow to emit a sound or murmur as it is going to the lungs. This murmur can often be heard as a distinct sound along the left front chest, the back and the sides of the infant.
Is it dangerous? Severe cases of peripheral pulmonary stenosis are rare and typically associated with other congenital heart conditions. These patients may require a catheterization or even surgical intervention to help open the narrowed arteries.
In newborns with otherwise normal hearts, PPS is usually a benign/innocent occurrence and will resolve on its own. In these mild cases, typically no treatment is required.
Some pediatricians will consider PPS to be resolved once the murmur is no longer heard. Other times a follow-up visit with the cardiologist may be desired. In either case, once peripheral pulmonary stenosis has resolved, the infant is considered normal and no further follow-up with the cardiologist is necessary.
Christy Glasow, M.D.
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